Final Exam 2 Med Surge
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| in the client with less than normal amounts of bicarbonate in blood and other extracellular fluids what response will the nurse anticipate | increase risk of acidosis
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| the nurse recognizes which response is an example of compensation for an acid base imbalance | increase of rate and depth of respirations when exercising
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| when a client has an arterial blood gas of 7.48, the nurse recognizes which action by the .....will help the ph go back to normal | release of hydrogen ions into the blood
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| when a client is NPO for 5 days and receiving 3L of crystalloid IV solution contain 5% dextrose daily what type of acid production could be expected to increase | ketoacids
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| in the client with hypoventilation which change in acid base would the nurse recognize as a compensatory response | increase arterial blood bicarbonate
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| in the client four minutes post cardiac arrest, the nurse correlates the largest source of excess hydrogen ions to which cause | cellular metabolism under anaerobic conditions leading to build up of lactic acid
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| the nurse recognizes that the lower levels of hgb affects acid base balance by which mechanism | decreases the ability to compensate for mild acidosis
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| the client has an arterial blood gas of 7.48 how will the nurse interpret the acid base status | the client has a deficit of blood hydrogen ion concentration
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| in the client of an arterial blood gas ph 7.42 what is the nurses interpretation of his or her acid base status | client has a normal blood hydrogen concentration because the pH is normal
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| the nurse monitors for which acid base balance in the client who has hypoxemia | excess carbon dioxide production acidosis
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| what acid base problem could result if a client is being mechanically ventilated is ventilated too high at a respiratory rate | acid deficient alkalosis
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| the nurse monitors for which acid base problem in the client lasix for hypertension | acid deficit secondary to metabolic alkalosis
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| the nurse correlates renal compensation for an acid base imbalance in which situation | hypoxemia from 4 days from pneumonia in an adult woman
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| the nurse determine which client at greatest risk for acidosis | the adult client with pneumonia
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| the nurse monitors for which acid base imbalance in a client who has acute pancreatitis | metabolic acidosis
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| the nurse assess acidosis for the client with which data | serum potassium level 6.5 and flaccid paralysis
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| the hand grasps of a client with acidosis has diminished sense the previous assessment one hour ago, what is the nurses best first action | assessing the clients rate and rhythm and depth of respirations
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| the client the following arterial blood gas results ph 7.12, HCO3 22, PCO2 65, PO2 56 , the nurse correlates these values to which clinical situation | complete tracheal obstruction related to an aspiration of a hot dog
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| which client will the nurse assess for potential metabolic acidosis | a young adult following carbohydrate free diet
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| the nurse interprets which arterial blood gas value as partially compensated metabolic acidosis | ph 7.32, bicarb 17 co2 25
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| the client has just experienced a 90 second grand mal seizure and has these arterial blood gas values ph 6.88, bicarb 22, co2 60 Po2 50, how will the nurse intervene | applying oxygen by mask or nasal cannula
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| the nurse teaches the client which intervention to decrease risk for development of metabolic acidosis | be sure to eat 3 well balance meals
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| the nurse recognizes which client most at risk for development for acute respiratory acidosis | a man undergoing a mechanical ventilation
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| the nurse correlates which condition to the following arterial blood gas values,ph 7.48, bicarb 22, co2 28, po2 98 | anxiety induced hyperventilation
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| the nurse monitors for which acid base imbalance in client who is receiving 6 units of packed red blood cells for the past 6 hours secondary to blood loss in surgery | metabolic alkalosis
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| the nurse correlates which arterial blood gas values as consistent with fully compensated respiratory acidosis | ph 7.35 bicarb 36, co2 65 po2 78
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| the nurse recognizes which client as at greatest risk for alkalosis | an adult client with critical illness receiving total parenteral nutrition
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| which assessment finding should the nurse expect in a client with salicylates poisoning | increase rate and depth of respirations
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| in a client with prolonged fever the nurse correlates this to which acid base imbalance | fever increases the rate of metabolism causing a metabolic acidosis by increasing the rate of carbon dioxide production
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| which statement by the client indicates the need for further education regarding an increase risk metabolic alkalosis | I take sodium bicarb after every meal to prevent heartburn
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| the client with chronic respiratory acidosis is receiving oxygen by nasal cannula at 6L now has a respiratory rate at 8 breaths per minutes what is the nurses best action | oxygen therapy can inhibit respiratory effort eventually causing death
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| which acid base imbalance should the nurse be most alert for when providing care to a client who has several broken ribs | respiratory acidosis
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| the nurse prepares to administer bicarbonate intravenously to a client with which clinical manifestations | ph 7.28 bicarb 16 co2 45 po2 98 secondary to excessive diarrhea
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| the nurse assess for which electrolyte disorder in a client with metabolic alkalosis | hypokalemia
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| A family of client with a mixed respiratory and metabolic acidosis secondary to bronchitis and diabetic ketoacidosis asks the nurse whether the clients confusion is likely to be permanent, what is the nurses best response | The confusion should clear as soon as the oxygen and electrolytes become normal
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| The nurse indicates which statement in a discharge teaching in a client who is going home and continues to be at risk for the development of metabolic alkalosis | avoid excess use of antacids
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| The nurse monitors which electrolyte level in a client in any type of acid base imbalance | potassium
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| The nurse monitors for which electrolyte value in the client with acidosis | potassium 5.8
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| Prior to the administration of IV fluid it is most important for the nurse to obtain which information from the healthcare provider | specific type of IV fluid
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| Which IV order would the nurse question | infuse 0.9 normal saline and keep vein open
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| when assigning a client having IV therapy to a licensed LPN which instruction is most important for the RN to provide | Hang a designated IV solution if permitted by the institution
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| Which infusion device will the nurse select for the older client with a medical diagnosis of dehydration | Cassette pump
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| What action will the nurse take to prepare packed red blood cells through a Goshon catheter | Use a pump to infuse the blood
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| The RN assigns a new nurse to a client who is receiving chemotherapy through a IV extension set attached to a Huber needle, which information about disconnecting the Huber needle is most important for the RN to provide to this nurse | the rebound effect
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| After discontinuing a nontunneled percutaneouse central catheter it is most important for the nurse to record which information | length of the catheter
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| when assessing the client's peripheral IV site the nurse observes a red streak along the vein path and palpates 4 cm venous cord, what is the most accurate documentation of this finding | Grade 3 Phlebitis at IV site
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| Which information is most important to teach the client going home with PICC line | avoid carrying grandchildren with the arm that has the IV
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| A client is to receive 10 days of antibiotic therapy for eurosepsis the nurse should select which IV catheter to replace | Midline catheter
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| As a result to the of the client's admission to the hospital for excessive nausea and vomiting and BP of 80/50, the nurse selects the access device most appropriate for the designated purpose | 20 gauge needle / catheter IV(dehydration)
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| To prevent infection when infusing a piggyback line which intervention is most important for the nurse | IV-Back priming
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| what is the initial action taken after completion of an intermittent medication administration through a Gushon catheter | Flush the line with normal saline
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| when examining a peripheral IV site the nurse observes a red streak along the length of the vein and the vein feels hard and cordlike,what is nurses next action | Removing catheter
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| when an IV pump alarms because of pressure what action will the nurse take first | Check for kink
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| the nurse is caring for 4 clients receiving IV therapy which client should the nurse assess first | Older adult with normal saline infusing
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| the client who is taking tunnel venus catheter inserted begins to complain of chest pain and difficulty breathing, what action will the nurse take first | Assist with insertion of a chest tube
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| the client who has just had a IV started in right cephalic vein tells the nurse that the wrist and hand below the IV site feels like “pins and needles” what is the nurses best action | discontinuing the IV and start it at another site
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| when changing the administration set of a central venous catheter it is most important for the nurse to carry out what intervention | Have the client hold his breath during the disconnection and reconnection
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| Home nurse administer IV med to the client reads in a chart that the PICC line in the clients lt arm has been in place for 4 weeks, IV is patent w good blood return and site is clean and free for manifestation of infiltrations, irritation and infection wh | Remain in months or even years
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| which assessment finding for client with PICC line requires immediate attention | Upper extremity swelling
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| when assessing a clients peripheral IV site the nurse notices edema and tenderness above the site what action will the nurse take first | STOP the infusion of IV fluids
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| What action should the nurse take to prevent an infection in the older patient receiving intravenous therapy | allow aseptic solutions to dry prior to dressing application
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| the nursing is caring for a client receiving epidural infusion for pain what action is has the highest priority | assessing respiratory rate
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| the nurse is caring for a client with radial arterial catheter, which assessment is of most concern | presence of ulnar pulse
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| 5 days after start of intraperitneal therapy the patient is complaining of abdominal pain and feeling warm the nurse recognizes that the client is most likely exhibiting symptoms of which condition | Infection
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| Which client would be the best candidate to receive hypodermoclysis for intravenous therapy | clients receiving pain management
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| the nurse is caring for a client with an intraosseous catheter placed in the leg 20 hrs ago what assessment is of most concern | legs cold to touch
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| a client asks why the nurse signs the operative consent form under her signature as a witness what is the nurses best response | it confirms that you voluntarily signed the form
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| the nurse is caring for an older adult client with a history of emphysema who will be undergoing to surgery the following day, which nursing diagnosis is the highest priority for this client | Risk for Impaired gas exchange
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| the nurse is completing preoperative teaching for a client and it becomes apparent the client does not understand the surgery will be performed. what is the priority action of the nurse | notify the surgeon and note the findings in the clients chart
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| when the nurse brings a client preoperative medication the client response i dont need that i had a good nights sleep last night what is the nurses best response | the medication will help prevent complications during the surgery
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| the client receiving preoperative medication tells the nurse that she took all of her vitamins and herbs last night before going to bed, which one will the nurse report to the surgical team | garlic
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| the nurse reviews the clients lab results prior to surgery, which findings will the nurse report immediately | Prothrombin time is elevated (15.2)
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| the client is brought to the emergency department after a motorcycle accident the client has suffered a ruptured spleen, which type of surgery will the client have | emergent
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| the nurse has just finished preoperative teaching with female client who will be having surgery the following day, which statement by the client indicates that additional teaching is needed | I will wear my lucky earrings tomorrow during surgery
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| the nurse is performing preop teaching to client who will be having colon resection srugery the following day the surgeon ordered bowel preparation for the client to be taken that night which statement by the client indicates that additional teaching is | i will take my antibiotics with a glass of OJ tonight
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| the client is scheduled to have surgery in the 2 hrs tells the nurse during the admission interview the following information what information should the nurse be certain to communicate on the outside of the chart for the entire surgical team to know | client is hard of hearing
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| the client is undergoing palative surgery begin an abdominal tumor, the clients daughter asks what is the surgery to be considered palliative what is the nurses best response | the surgery will relieve the symptoms of the bowel obstruction and will not cure your father
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| 20 minutes after the client receiving preoperative injection of Atropine and Versed, the client tells nurse that he must be allergic because mouth is dry and heart seems to be beating faster than normal, what is the nurses priority acton | ssess the clients pulse and blood pressure
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| the client under going preoperative assessment before an elective procedure tells the nurse that she has been taking 10 mg of prednisone daily for her rheumatoid arthritis what is the nurses best action | notify the surgeon and anesthesiologist
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| the preoperative client tells the nurse she has allergies to several substances which allergy presents the greatest potential problem considering the schedule of surgery | shrimp/shellfish
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